Healthcare Provider Details
I. General information
NPI: 1932728813
Provider Name (Legal Business Name): RACHEL HANSEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2020
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
680 E MAIN ST STE 201
LEHI UT
84043-2251
US
IV. Provider business mailing address
680 E MAIN ST STE 201
LEHI UT
84043-2251
US
V. Phone/Fax
- Phone: 801-514-7100
- Fax: 801-514-7200
- Phone: 801-514-7100
- Fax: 801-514-7200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 11910100-1206 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | 11910100-1206 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: